Provider Demographics
NPI:1205612942
Name:GIFTED STICKS MOBILE PHLEBOTOMY SERVICES LLC.
Entity type:Organization
Organization Name:GIFTED STICKS MOBILE PHLEBOTOMY SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPT-1
Authorized Official - Prefix:MS
Authorized Official - First Name:MILENE
Authorized Official - Middle Name:KRISTIAN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:CPT-1
Authorized Official - Phone:626-391-9779
Mailing Address - Street 1:2108 N ST STE 8581
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5712
Mailing Address - Country:US
Mailing Address - Phone:661-230-9796
Mailing Address - Fax:
Practice Address - Street 1:4254 E AVENUE S4
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-5143
Practice Address - Country:US
Practice Address - Phone:626-391-9779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty